Provider Demographics
NPI:1972774818
Name:MICHAEL R NAWFEL DMD PA
Entity type:Organization
Organization Name:MICHAEL R NAWFEL DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:NAWFEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:207-872-2889
Mailing Address - Street 1:46B FIRST PARK DRIVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04963
Mailing Address - Country:US
Mailing Address - Phone:207-872-2889
Mailing Address - Fax:207-872-7159
Practice Address - Street 1:46B FIRST PARK DRIVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:ME
Practice Address - Zip Code:04963
Practice Address - Country:US
Practice Address - Phone:207-872-2889
Practice Address - Fax:207-872-7159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME29711223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty